RT journal article
T1 Increasing importance of European lineages in seeding the hepatitis C virus subtype 1a epidemic in Spain
A1 Pérez, Ana Belén
A1 Vrancken, Bram
A1 Chueca, Natalia
A1 Aguilera, Antonio
A1 Reina, Gabriel
A1 Garcia-del Toro, Miguel
A1 Vera, Francisco
A1 Von Wichman, Miguel Ángel
A1 Arenas, Juan Ignacio
A1 Téllez Pérez, Francisco de Paula
A1 Pineda, Juan Antonio
A1 Omar, Mohamed
A1 Bernal, Enrique
A1 Rivero-Juárez, Antonio
A1 Fernández-Fuertes, Elisa
A1 de la Iglesia, Alberto
A1 Pascasio, Juan Manuel
A1 Lemey, Philippe
A1 Garcia, Federico
A1 Cuypers, Lize
A2 Medicina
A2 Medicina
AB Background: Reducing the burden of the hepatitis Cvirus (HCV) requires large-scale deployment of interventionprogrammes, which can be informed by thedynamic pattern of HCV spread. In Spain, ongoingtransmission of HCV is mostly fuelled by people whoinject drugs (PWID) infected with subtype 1a (HCV1a).Aim: Our aim was to map how infections spread withinand between populations, which could help formulatemore effective intervention programmes to halt theHCV1a epidemic in Spain. Methods: Epidemiologicallinks between HCV1a viruses from a convenience sampleof 283 patients in Spain, mostly PWID, collectedbetween 2014 and 2016, and 1,317, 1,291 and 1,009samples collected abroad between 1989 and 2016were reconstructed using sequences covering the NS3,NS5A and NS5B genes. To efficiently do so, fast maximumlikelihood-based tree estimation was coupled toa flexible Bayesian discrete phylogeographic inferencemethod. Results: The transmission network structureof the Spanish HCV1a epidemic was shaped by continuousseeding of HCV1a into Spain, almost exclusivelyfrom North America and European countries. The latterbecame increasingly relevant and have dominated inrecent times. Export from Spain to other countries inEurope was also strongly supported, although Spainwas a net sink for European HCV1a lineages. Spatialreconstructions showed that the epidemic in Spainis diffuse, without large, dominant within-countrynetworks. Conclusion: To boost the effectiveness oflocal intervention efforts, concerted supra-nationalstrategies to control HCV1a transmission are needed,with a strong focus on the most important drivers ofongoing transmission, i.e. PWID and other high-riskpopulations.
PB EUR CENTRE DIS PREVENTION & CONTROL
SN 1560-7917
YR 2019
FD 2019-02
LK http://hdl.handle.net/10498/21330
UL http://hdl.handle.net/10498/21330
LA eng
DS Repositorio Institucional de la Universidad de Cádiz
RD 14-nov-2026